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Wednesday, May 11, 2011

Phoenix continued

I completely underestimated how much treatment for my leg injury was going to take out of me both emotionally and physically. This healing stuff is hard work. I am on the quick recovery program here due to my own time constraints, so Dr. Ball has to work his magic on a compressed schedule, and that is not ideal. We have been balancing the intensity and frequency of treatment with how well my body recovers all the while testing the treatment with short and long runs. It became clear yesterday during my afternoon run that I was having a hard time telling apart the discomfort from treatment and that of the original issue.

So, I made a decision to stay in Phoenix through next Tuesday. I am making remarkable progress (in my mind at least), but Dr. Ball mentioned that, if he wasn't under a time constraint with me, he would give me a rest from treatment to allow my body to recover and to truly test the effects. It seems wrong to push my body harder or truncate my treatment at this point given how far I have come and how much more I have to go. I want to let the treatment sink in and get as much of the junk cleared out of my system as possible.

That's what we're doing here: clearing junk from my trunk. I had no idea how much junk I had in there either and most of it was hidden. I am going to make one sweeping disclaimer here that I may not get all of the details completely right, and that is a factor of my monkey brain, not Dr. Ball's. He does a great job of explaining all of this, but there is a limit to how much I can absorb. He mentioned at some point that I had the most messed up adductor/hamstring "cluster" (my term) that he had seen in a long, long time. Here's how I understand my main problem (there are other minor issues): my hamstrings and adductors are fused together which doesn't let me use them properly when I run. This forces my hips/butt to work overtime to actually move forward with a stride. At some point, my glutes and hips get tired of doing what I'm asking them to do because they're not designed to do this, and they cry uncle. This is usually my tensor fascia latae (TFL) crying out or it might be a quad muscle. The good old IT band is attached to the TFL and starts to get pulled when the TFL tightens. That's when I feel the knee pain.

As part of this exploration, I received a wonderful consult from a coach in Australia, Keith Bateman, who specializes in helping people with form issues. He was able to create stills from a video of me running. It was very interesting to see how awful I looked compared to what I should be doing. For some reason, a prancing horse is what I see in these images. From one shot, it was clear that I am too upright, I use my calf muscles to propel myself (maybe lob is a batter term) forward instead of my hamstrings, my front foot is lazily dangling rather than being dorsiflexed and that all has a ripple effect that plays out in the rest of my stride. When I first saw these images a couple weeks back, I felt empowered with this new knowledge and set out to improve my stride with form drills and paying attention to my forward lean, etc.

What I didn't know then was that I couldn't get there by willing it or even trying harder. My form sucks, in part, because my body is not functioning properly. The most humbling thing I've done with Dr. Ball is simple forward lunging. I posted a video of my flexibility tests on YouTube for him originally, and it is painfully clear that I'm having problems doing a simple forward lunge. He asked me the first day we met how in the world I could run a 2:45 marathon when I couldn't even do a simple forward lunge without struggling. I can't lunge not because I'm weak. No amount of strength work or stretching will make me a better lunger. I can't lunge because my body is stuck. My hips are stuck, my hamstrings are stuck, my adductors are stuck and this has been building up for years and years. It is an interesting take on how I've typically thought about my body and how it functions.

How did I get to this point? Well, by running a lot of miles. Dr. Ball reassured me that my body is doing all the right things. I go out for a hard run and it repairs the damage with temporary patches and communicates with me the next day through muscle soreness that I have done damage. Surely, my body thinks, I will listen to the cries to stop doing this activity and let it do some more substantial repair work, but my brain overrides this and we (my brain and I) go out and do it again. So, imagine all of these little band-aid patches being applied over and over in the same spots. Eventually, dysfunction arises when a substantial trigger point/knot/adhesion forms and the muscle no longer has the elasticity, range of movement and therefore function that it should. So, the body compensates. Adhesions form in other places. Pretty soon there's just a whole lot of compensation going on and a pile of band aids being thrown down on top of band aids. Something has to give. That's where I was 6 months ago after the Chicago Marathon and have remained. Looking back, I thank Dog that my body held up through that race.

The relief I've gotten with the various forms of therapy I've tried so far have served to alleviate a small bit of the problem. As Dr. Ball explains it, I don't just have IT band syndrome, I have IT Band syndrome + glued adductors + locked hips + a locked lower back +.... Relieve one of these things, and you get marginal improvement, but a problem will come back. So, your goal has to be to eliminate as much of the dysfunction as possible to break the chain.

That's what he has been attempting to do with me: jackhammer away at the concrete in my muscles and make it so they function properly. The difference in how my legs feel is amazing. They feel light and free when I run now. I feel effortless. This is a very exhausting process, and he and his team at Maximum Mobility Chiropractic have been working their butts off on me. Dr. Ball uses active release therapy (ART) mostly, but he does it as a team with someone moving my leg through a certain motion while he strips out the adhesions with his hands. All he has to say to his partner is "capsule" and they know exactly how to move my leg. He also uses an EPAT (extracorporeal pulse activation therapy) machine to "soften" the tissue and it feels like a jackhammer smacking your leg. It works. After this abuse, I go out and do a test run and come back in to report back. On Monday, I spent probably 3-4 hours in the office and test ran for about 80 minutes total. I am really starting to notice a difference.

The good news for all of us is that once these adhesions are cleared, they take a long time to lay down again and build up. Dr. Ball hasn't yet shared the simple measures I will take to maintain my shiny new body in this functional condition, but he assures me it won't be hard.

In the end, I don't think there is any magic to what Dr. Ball does here in the desert. He's a careful observer but mostly he knows what to look for. Most of all, he is super dedicated to his patients with a main goal of aiming for functional improvement rather than just symptom relief. Finding someone who has this combination is absolutely rare which is why I've shared the waiting room with a parade of the nation's best runners this week. Yesterday, he kept talking about how he was unique and that I would never be able to find anyone else out there as good as him. It took him about three tries with this comment before I got that he was being absolutely sarcastic. I won't let him get away with that today.